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General NPI Number Information
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NPI Number | 1851127096
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Entity Type | Individual
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Provider Name | OLUBUNMI M COLE PMHNP-CNP
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Gender | Female
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1500 S MAIN ST
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City | FORT WORTH
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State | TX
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Zip | 76104-4917
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Country | US
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Telephone | 972-207-0956
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Fax |
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Provider Business Mailing Address
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Address Line | 2919 BLACKSMITH CT
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-4578
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Country | US
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Telephone | 972-207-0956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1174201
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License Number State | TX
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